The preemptive analgesia under general anaesthesia combined with epidural anaesthesia

Objective To study the influence of epidural anaesthesia in different time and different induced drugs of general anaesthesia on postoperative analgesia under general anesthesia combined with epidural anaesthesia. Methods 120 patients of performing hepatoma and carcinoma of stomach are divided randomly into A, B, C ,D group,30 patients in each group. Group A: 1% lidocaine and 0.25% bupivacaine 6～8 ml were infused into epidural space at T8-9,followed by 10 ml normal saline containing morphine 2mg and droperidol 2.5mg. Induced drugs of general anaesthesia were Fentanyl 3μg·kg-1,Propofol 1～1.5mg·kg-1,Succinycholine 2mg·kg-1. Group B: Fentanyl was not used in Induction and maintenance of general anesthesia and replaced by lidocaine 1～1.5mg·kg-1,other conditions were similar to group A. Group C: After epidural puncture at T8-9, Induced drugs of general anaesthesia were Fentanyl 3μg·kg-1,Propofol 2～2.5mg·kg-1,Succinycholine 2mg·kg-1,fentanyl was used if necessary. After 90 minute of incision,1% lidocaine and 0.25% bupivacaine 6～8 ml were infused into epidural space at T8-9,followed by 10 ml normal saline containing morphine 2 mg and droperidol 2.5mg .Group D:fentanyl was not used in induction and during operation, which being replaced by lidocaine 1～1.5mg·kg-1 in induction. Other conditions were similar to group C.VAS score, analgesic drug consumption, nausea, vomit, pruritus were observed at 4h,8h,24h and 48h after operation. Results The effect of analgesia was the best in group A and analgesic drug consumption was lesser,followed by group B and group C. Group D was the worst. Conclusion The effect of analgesia is the best when fentanyl and epidural anaesthesia are used at the same time under general anaesthesia combined with epidural anaesthesia.